Life in the ER: 'You never know what's going to come through that door'

Diane Murphy lay in a hospital bed on an early October evening, her neck strained after a car accident, discussing with Dr. Leon Yeh her course of treatment and what she'd do if she won the lottery. From factory accidents and motorcycle crashes to strokes and drug overdoses, 87,000 patients w...

For more on the changing face of Peoria health care, pick up a copy of our special section in Sunday's Journal Star and look for daily posts here.

Diane Murphy lay in a hospital bed on an early October evening, her neck strained after a car accident, discussing with Dr. Leon Yeh her course of treatment and what she'd do if she won the lottery.

From factory accidents and motorcycle crashes to strokes and drug overdoses, 87,000 patients were treated in 2012 for illness and injury in the OSF Saint Francis Medical Center Emergency Department.

Some required of only a few minutes of attention for a sore throat or stitches, while others might be admitted for days, weeks or months after a major injury.

"You see people at their darkest hour or their most traumatized," said Yeh, medical director of emergency services. "It takes a lot of focus on people to not just see the condition. It's important to put yourself in the patient's position or the family's position and realize this might be the worst day of their lives."

About 20 percent of the patients who visit the ED will be admitted to the hospital for treatment. The others are monitored, treated and logged before the room is cleared and cleaned for the next patient.

"You never know what's going to come through that door. We could have a gunshot wound and five minutes later a kid with an asthma attack," second-year resident Dr. Ashley Huff said.

"Every once in a while somebody comes in with their heart stopped and we get it going again. Those are good nights."

The variety and urgency is what attracts doctors such as Yeh to the Emergency Department, not simply an "emergency room" filled with hurried physicians ducking behind the crowded curtains of a Hollywood drama, but an often quiet center for acute care, with six pods divided into 50 private rooms.

With as many as six attending physicians and 26 nurses working at peak hours in addition to the residents completing their training working in the ED, patients could see multiple medical professionals in one visit, along with specialists, technicians or social workers.

Some functions of the ED are less urgent than others, such as treating chronic illnesses, providing health care to those who don't have access to primary care physicians or housing psychiatric patients until a spot in an appropriate facility opens up.

But when the need for immediate actions arises, the ED staff is ready to deliver life-saving treatment.

When a charge nurse at the front desk is alerted by ambulance technicians that a trauma patient is expected to arrive - whether injured in a crash, fall, assault, stabbing or shooting - a team of doctors throughout the hospital will assemble in a special room where patients can go from ambulance to hospital bed in a matter of seconds with up to a dozen doctors ready upon arrival.

Page 2 of 2 - They know the "golden hour" of trauma, treatments administered in the first hour after injury, can make the difference of survival.

When it comes to treating patients during and after a stroke, the St. Francis ED staff holds the unofficial world record in delivering special blood thinning medication within five minutes of patient arrival, Yeh said.

Sometimes it takes a team of talented and dedicated doctors to save a single patient's life - hours of medical care or resuscitation in extreme circumstances.

"Many of us will follow up with a patient to keep an eye on things, and just talk to our colleagues for some closure. . . . We review what could have been done better, but also to validate our emotions," Yeh said.

"No single person would be able to do this alone."

______

OSF Saint Francis Emergency Department

?87,528: Number of cases treated in the Saint Francis Emergency Department in 2012

?Top 5 causes of injury

1. Motor vehicle crashes

2. Falls

3. Motorcycle crashes

4. Violence (assaults and stabbings)

5. Gunshot wounds

?From January through September 2013, Saint Francis staff treated 1,196 trauma patients in the Emergency Department. Seventy-three of those patients died.